FISTULA-IN-ANO

CAUSES, SIGNS & SYMPTOMS, HOMEOPAHTIC MANAGEMENT AND PREVENTION

What is Fistula-in-ano?

Fistula means a canal-like structure which opens at two ends. However, in Medicine / Surgery, fistula or fistula-in-ano refers to a common painful disease where there is a canal, one end of which opens in the rectum or anus and the other on the skin of the buttock or somewhere in the rectum.

What are the causes of Fistula ?

Repeated Infection of anal glands leading to abscess formation

Poor hygienic practice

Diabetes

Sexually transmitted diseases

TB

Hereditary tendency

What are signs and symptoms of Fistula ?

Throbbing constant pain [when sitting] in anus (back passage)

Secretion of pus, mucus, blood from opening around anus

Swelling, tenderness, redness of skin around anal orifice

Fever

Constipation

Patients report pain specially when there is swelling around anus

Patients report relief when pus oozes out and swelling gone

How is Fistula managed with Classical Homeopathy ?

General Discussion:

Therapeutically there are a lot of medicines that may be used for patients of fistula-in-ano, like Aloe soc., Acid nit.,…… However, it may be mentioned, therapeutic aims at managing acute stage of the disease only; since this website is dedicated to managing chronic patients with classical homeopathy, we will take up a case or two of chronic in nature.

Case Study 1:

Mr. P. Bhatnagar age 40+ reported that he was suffering from fistula for last one year or so. A few days back, he consulted a surgeon who suggested, after clinical and proctoscopical examination, there was no other alternative but surgery in his case. He came to me to know if surgery could be avoided. He was told that such cases had been successfully treated before, however, direct guarantee of cure was beyond our scope of medical ethics. Mr. Bhatnagar left the clinic with remarks that let him think over the issue for few days.

After three days, he reappeared and on query narrated the following:

Addiction:

1)He was a chain smoker of cigarette for about last 15 yrs. However, meanwhile, he decreased the rate of smoking to 10 cig. a day;

2)He also took hard drinks 2 pegs a day for last 10 yrs.

Chief complaints:

1)Occasional feeling of a swollen mass around anus with pain and tenderness which was relieved by application of hot fomentation;

2)His undergarments used to get soiled with yellowish brown stain which was very difficult to wash off;

3)During pain and tenderness he used to feel relieved remaining in bed;however, sometimes, he was forced to go to office by scooter which led to worsen the pain further;

4)He also used to notice stain of a drop of blood on his undergarments occasionally; suffered from constipation from time to time specially when swollen mass and pain felt in the back passage.

Past history :

Nothing in particular except occasional cough and cold. He has a little tendency to catch cold easily but not enough to cause any serious trouble.

Family history :

1)Mother died of pleurisy;

2)Father died of diabetes;

3)Grandma and one maternal uncle suffered from fistula-in-ano.

Mental Generals:

1)Likes music very much, even favourable music relieved his pain;

2)Fears dogs, darkness;

3)Sleep disturbed, cried out during sleep – as reported by family members.

Physical Generals:

1)Crave meat, spicy foods, cold soft drinks;

2)Thirst : almost nil, but he used to take about 2 liter a day.

1st Prescription:

Tuberculinum 1M / 2 doses – 1 TSF is to be taken after 1hr and a half after supper mixing 1 dose with 1 cup of water. Next morning 1 dose is to be taken following the same procedure in empty stomach. Advice : cig. to bring down to 5 a day; hard drinks to stop totally; to take enough green salad and fruits with dinners; avoidtaking meat; continue drinking water as it was; Review after 3 weeks.

2ndPrescription:

Patient appeared as advised and reported no complaint. He was advised to stop cig. totally; to reappear after a month, however, in case of problem, he was free to attend on any day. Only a few doses of supportive medicine were given.

Follow Up:

Patient reported no complaint. He informed that he had stopped smoking, drinking and taking meat totally. He was properly appreciated to strengthen his decision to refrain from addictions. He was also told that his determination to shun addictionstogether with medicine paved the way of his wellbeing. He was released with advice wait and watch, if necessary, to attend clinic.

PREVENTION:

Diabetics, persons with tubercular diathesis and those having hereditary trend of fistula should take care to adopt good hygienic habits, avoid promiscuous sex and red meat. It has been observed that this disease is related to liver function in someway or other. As such, practising precautionary measures to keep the liver healthy should be adopted – these are given under sub-menu ‘Keep Liver Healthy’ under menu ‘Patients’ corner’.